Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $128.82 / $128.82	Facility	26	$112.20	$128.82	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $489.78	Professional		$169.82	$275.42	$489.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $85.11 / $218.78	Professional	26	$53.70	$85.11	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $181.97 / $309.03	Professional	TC	$114.82	$181.97	$309.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $309.03 / $1,000.00	Professional		$169.82	$309.03	$1,000.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $87.10 / $331.13	Professional	26	$56.23	$87.10	$331.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $223.87 / $660.69	Professional	TC	$112.20	$223.87	$660.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $138.04 / $213.80	Professional		$72.44	$138.04	$213.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $177.83 / $281.84	Facility	26	$151.36	$177.83	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $436.52 / $707.95	Professional		$194.98	$436.52	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $120.23 / $234.42	Professional	26	$53.70	$120.23	$234.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $316.23 / $467.74	Professional	TC	$144.54	$316.23	$467.74
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $380.19 / $575.44	Professional		$316.23	$380.19	$575.44
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $128.82 / $173.78	Professional	26	$104.71	$128.82	$173.78
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $251.19 / $416.87	Professional	TC	$208.93	$251.19	$416.87
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $537.03 / $537.03 / $537.03	Facility	26	$537.03	$537.03	$537.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $457.09 / $1,862.09	Professional		$229.09	$457.09	$1,862.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $128.82 / $436.52	Professional	26	$63.10	$128.82	$436.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $338.84 / $1,905.46	Professional	TC	$154.88	$338.84	$1,905.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $309.03	Professional		$32.36	$33.11	$309.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $426.58 / $1,122.02	Professional		$218.78	$426.58	$1,122.02
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $524.81 / $524.81	Facility	26	$134.90	$524.81	$524.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $1,096.48 / $1,949.84	Professional		$263.03	$1,096.48	$1,949.84
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $302.00 / $436.52	Professional	26	$72.44	$302.00	$436.52
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $891.25 / $1,905.46	Professional	TC	$181.97	$891.25	$1,905.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $954.99 / $1,445.44	Professional		$741.31	$954.99	$1,445.44
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $213.80 / $275.42	Professional	26	$199.53	$213.80	$275.42
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $575.44 / $741.31	Professional	TC	$407.38	$575.44	$741.31
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $346.74 / $741.31	Professional		$199.53	$346.74	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $95.50 / $218.78	Professional	26	$61.66	$95.50	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $257.04 / $575.44	Professional	TC	$134.90	$257.04	$575.44